Which Painkiller Should I Take?

This article has been medically approved by Superintendent Pharmacist Shilpa Shailen Karia, MRPharmS. - GPhC Reg No: 2087328

Different Pain Relief Options

The type of medicine depends on the type of pain you have, but how do you know which is which? Check out our article below for more information on common painkillers and when they should be used.

Generally, for pain associated with inflammation, paracetamol or anti-inflammatory painkillers work best. Types of pain could be back pain, period pain, or headaches.

If the pain is caused by sensitive or damaged nerves, tablets that change the way the central nervous system works work best. Types of pain could be shingles, sciatica, or a pinched nerve.

However, you should always remember that all painkillers have potential side effects. You should weigh up the advantages or disadvantages of taking them.

Paracetamol

Paracetamol is used to treat most non-nerve pains.

Do not take more than the recommended dose. This can be found in the enclosed leaflet, or you can contact your prescriber if it is prescribed. You should never take more than 8 tablets in a 24-hour period. Overdosing on paracetamol can cause serious side effects. If the pain is severe, or lasts for longer than 3 days, see your GP.

Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). Other NSAIDs include diclofenac and naproxen. These drugs seem to work better when there’s clear evidence of an inflammatory cause – like arthritis or after injury. You shouldn’t take NSAIDs for long period unless you have discussed this with your doctor, as there is an increased risk of kidney and heart problems, and stomach upset, including bleeding and ulcers.

Do not take more than the recommended dose and pregnant women should not take ibuprofen unless a doctor recommends and prescribes it.

Taking Ibuprofen with Coronavirus (COVID-19)

Recently there has been speculation that Ibuprofen exacerbates the symptoms or upper respiratory diseases. There are currently no studies to prove or disprove this, but NHS England have stated, "until we have more information, take paracetamol to treat the symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you."[1] However, those who are taking ibuprofen on advice of a doctor should not stop taking it.

Aspirin

Aspirin is another type of NSAID but is not as effective as a painkiller. Children under 16 shouldn’t be given aspirin unless their doctor prescribes it, and there is a possible link between aspirin and Reye’s syndrome in children.

Codeine

Codeine works best when combined with paracetamol in a single pill. This is called co-codamol. Low dose co-codamol can be bought over the counter. Higher-dose codeine needs to be prescribed. It is not recommended to take codeine or other medium-strength painkillers for a long time as you can become dependent on them. If you are worried that you have become dependent on your painkillers, you should contact your GP or other healthcare professional for advice.

Amitriptyline and gabapentin

Amitriptyline is a drug to treat depression and gabapentin is a drug to treat epilepsy. However, each of these can also be used to treat nerve pain like shingles, sciatica, and diabetes. Amitriptyline and gabapentin both have to be prescribed by a GP, but you don't have to have depression or epilepsy to use them to treat nerve pain. Side effects include drowsiness and dizziness.

Morphine

Morphine and morphine-like drugs such as oxycodone, fentanyl and buprenorphine are the strongest painkillers available. Depending on your circumstances, these painkillers may be prescribed as a patch, injection, or a pump you control yourself. They all work in similar ways and should only be used for severe pain. These painkillers need to be prescribed after a consultation with a doctor or pain specialist, and they will closely monitor your dose and response. These drugs should only be used as art of a long-term pain management plan.

Soluble Painkillers

An alternative way to take painkillers is sometimes using soluble painkillers. However, soluble painkillers are often high in salt - containing up to 1g of salt per tablet. Too much salt can raise your blood pressure, which can put you at an increased risk of health problems like heart disease and stroke. You may want to try to get a low salt effervescent, or a non-effervescent painkiller, especially if you have been advised to watch or reduce your salt intake.

It is important to remember that you should ensure you read and understand the provided information before beginning to take any painkiller. If you have bought painkillers over the counter, you should read the enclosed leaflet to calculate your dosage. There may be a range of different dosages available to you, so make sure you read the provided information every time. If you have had painkillers prescribed, your doctor or healthcare professional should explain your dosage to you. If you are unsure, you should contact them.

Some painkillers that are suitable for adults are not suitable for children. If you require painkillers for a child, you should look for products designed for children like Calpol or Nurofen for Children

Article References

[1] https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/